Receipt of Anticoagulant Rx in ED Linked to Use at Six Months

For patients aged 65 years or older with atrial fibrillation, receipt of a prescription for an oral anticoagulant in the emergency department is associated with increased use of oral anticoagulants at six months, according to a study published online in CMAJ, the journal of the Canadian Medical Association.

Clare L. Atzema, M.D., from the University of Toronto, and colleagues conducted a retrospective cohort study involving patients aged 65 years or older who visited the emergency department between 2009 and 2014 and had a primary diagnosis of atrial fibrillation.

The researchers found that 18.9 percent of the 2,132 eligible patients were given a prescription for an oral anticoagulant in the emergency department. After weighting, 67.8 and 37.2 percent, respectively, of the patients who were given and were not given a prescription in the emergency department had filled a prescription for an oral anticoagulant at six months (absolute risk increase, 30.6 percent; number needed to treat, 3). The absolute risk increase was 23.2 percent and the number needed to treat was 4 at one year. No significant differences were seen in rates of death, stroke, or bleeding events.

"Physicians working in the emergency department should consider initiating oral anticoagulants in similar patients who are being discharged home, because this action is associated with improved use of stroke prevention long after the patient leaves the emergency department," the authors write.

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